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In the influential 1995 article “Social Conditions as Fundamental Causes of Disease,” Bruce Link and Jo Phelan described social and political factors as “fundamental causes” of death and disease. Whitney Pirtle has recently declared racial capitalism another such fundamental cause. Using the case of the water crisis in Flint, Michigan, she has argued that racial capitalism's role in that situation meets each of the criteria Link and Phelan's article outlines: racial capitalism influenced multiple disease outcomes, affected disease outcomes through multiple risk factors, involved access to flexible resources that can be used to minimize both risks and the consequences of disease, and was reproduced over time through the continual replacement of intervening mechanisms. We argue for Pirtle's conclusion using the extensive literature on racial capitalism and case studies concerning housing in the United States and Brazil and what Naomi Klein has termed “corona capitalism” in India. If races correspond to hierarchies of material security, as suggested by Ruth Wilson Gilmore, then these hierarchies and their causal effects are fundamental determinants of public health.

Research about autism spectrum disorder (ASD) in sub-Saharan Africa is sparse and limited. However, research studies coming from Nigeria in West Africa as a country have contributed significantly to the subject of ASD in sub-Saharan Africa. This study is a scoping review of research literature on ASD in Nigeria through June 2017 conducted by searching the key terms autism and Nigeria on PubMed and Google Scholar. Included in the review are works concerning case reports and co-morbidities associated with ASD in Nigeria; prevalence of ASD; genetic study of ASD; clinical characteristics of children with ASD; knowledge and awareness about ASD; socio-cultural factors affecting ASD. Expert opinion on social policy and public health issues affecting ASD in Nigeria are discussed. Wide research and intervention gaps are noted and we suggest directions for future research, social policy development, and intervention services for individuals with ASD in Nigeria.

IntroductionRapid, robust and continually updated evidence synthesis is required to inform management of COVID-19 in pregnant and postpartum women and to keep pace with the emerging evidence during the pandemic.Methods and analysisWe plan to undertake a living systematic review to assess the prevalence, clinical manifestations, risk factors, rates of maternal and perinatal complications, potential for mother-to-child transmission, accuracy of diagnostic tests and effectiveness of treatment for COVID-19 in pregnant and postpartum women (including after miscarriage or abortion). We will search Medline, Embase, WHO COVID-19 database, preprint servers, the China National Knowledge Infrastructure system and Wanfang databases from 1 December 2019. We will supplement our search with studies mapped by Cochrane Fertility and Gynaecology group, Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), COVID-19 study repositories, reference lists and social media blogs. The search will be updated every week and not be restricted by language. We will include observational cohort (≥10 participants) and randomised studies reporting on prevalence of COVID-19 in pregnant and postpartum women, the rates of clinical manifestations and outcomes, risk factors in pregnant and postpartum women alone or in comparison with non-pregnant women with COVID-19 or pregnant women without COVID-19 and studies on tests and treatments for COVID-19. We will additionally include case reports and series with evidence on mother-to-child transmission of SARS-CoV-2 in utero, intrapartum or postpartum. We will appraise the quality of the included studies using appropriate tools to assess the risk of bias. At least two independent reviewers will undertake study selection, quality assessment and data extraction every 2 weeks. We will synthesise the findings using quantitative random effects meta-analysis and report OR or proportions with 95% CIs and prediction intervals. Case reports and series will be reported as qualitative narrative synthesis. Heterogeneity will be reported as I2 and τ2 statistics.Ethics and disseminationEthical approval is not required as this is a synthesis of primary data. Regular updates of the results will be published on a dedicated website (https://www.birmingham.ac.uk/research/who-collaborating-centre/pregcov/index.aspx) and disseminated through publications, social media and webinars.PROSPERO registration numberCRD42020178076.

Respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon tumor-like lesion that has been reported within the nose, paranasal sinuses, and less frequently in the nasopharynx. While it is believed to be benign, its clinical presentation, radiological characteristics, and microscopic features may closely mimic more aggressive tumors of the upper respiratory tract, potentially leading to needless life-altering treatment. Prior to now, there had been no reported cases of this lesion in West Africa. We present a 35-year-old male with persistent bilateral nasal obstruction, difficulty with swallowing, and bilateral reduction in hearing, whose CT findings were highly suggestive of a nasopharyngeal tumor, but upon biopsy and histology showed features most consistent with REAH. Surgery completely alleviated his symptoms with no clinical evidence of recurrence after a 1-year follow-up period.

Flooding is the most common of all environmental hazards with vast devastating effect due to enormous losses to lives and properties world-wide, annually. Thus, the effect of extreme flooding is dramatic, not only at the individual household level, but in the country as a whole. This study focuses on flood risk assessment based on urban and coastal flood estimation due to the physical peculiarity of the Lagos region and her urbanization characteristics. It involves creating a flood change detection using GIS approach with the aid of a Cellular Automation Framework to simulate flooding in Lagos Metropolitan area, mapping out the flood prone areas and generating a flood vulnerability map for flood management and planning purposes. At twenty minutes intervals the discharge distribution for the different flow regimes (Low, Medium and Extreme) display flow duration between 60–120 min while the time of concentration is attained at 1 h 20 min (80 min).

Introduction. Endometriosis is defined as a chronic gynecologic disease which is characterized by the presence of endometrial glands and stroma in anatomical sites and organs outside the uterine cavity. The exact prevalence of endometriosis is difficult to determine because many women remain asymptomatic. However, endometriosis affects about 10% to 15% of women. Thoracic endometriosis (TES) is the most common endometriosis outside the abdominopelvic cavity. It refers to endometriosis within the thoracic cavity including the lung parenchyma, diaphragm, and pleural surfaces. It can manifest as catamenial chest pain, pneumothorax, hemoptysis, hemothorax, catamenial haemoptysis, and pulmonary nodules. Case Summary. A 39-years-old married female presented with recurrent right-sided chest pain of 22 years duration, recurrent cough of more than 20 years and progressive breathlessness of a month duration. The chest pain is pleuritic, and it often starts few days to the onset of her menses and lasts throughout menstrual flow only to abate after the stoppage of menstrual bleeding. Cough was unproductive, paroxysmal often worse with worsening chest pain. It disappears after the end of menstrual bleed. Breathlessness was initially on mild to moderate exertion before progressing to occasional breathlessness at rest. No history of orthopnea, paroxysmal nocturnal dyspnea, and pedal swelling was found. Over the years, she had presented to several clinics where she was said to have menstrual pain referred to the chest. Conclusion. Diagnosis of extrapelvic endometriosis can be challenging and delayed because it presents in a myriad of ways and in some cases, it may be difficult to link symptoms and the menstrual cycle.

Aim/purpose - This study examines the relationship between leverage and financial performance of Nigerian firms between the years 2007 and 2016. Design/methodology/approach - The study adopted ex-post facto research design to retrieve and study data for events which were already in existence. Inferential statistics adopted econometrics models with a concentration on panel data using regression analysis to achieve the three specific objectives of the study. The surrogates for the independent variable (financial leverage) were Debt Ratio (DR); Debt-Equity Ratio (DER); and Interest Cover Ratio (ICR) while Return on Capital Employed (ROCE), the only dependent variable, was used as financial performance proxy. Three control variables - Firm Size (SZ), Sales Growth (SG) and Growth in Gross Domestic Product (GGDP) were included in the model to capture other firms - specific and macroeconomic variables that may have an influence on the financial performance of the selected firms. Findings - The Random Effects Generalised Least Squares (REGLS) revealed a positive and significant effect between leverage (DR and DER) and ROCE (p < 0.05). However, ICR has a positive but insignificant effect on ROCE (p > 0.05). The outcome of the study was consistent with the Static trade-off theory of capital structure. Research implications/limitations - The study suggests that firms should continuously employ debt capital in order to benefit from available tax shields which ultimately enhance profitability. The limitation of the study is that only firms in the food and beverage sector in Nigerian business environment were covered by the study. Originality/value/contribution - The study contributed to the existing theory and literature by using empirical evidence from an emerging market to bridge the existing gap in knowledge of the effect of leverage on the performance of firms.

Owing to the scarcity of feed during the dry season in most tropical regions of Africa, attention has been shifted to the use of aquatic plants which were regarded as waste and take a lot of effort to eradicate. This study therefore aimed to explore the potential of water hyacinth as alternative feed source for ruminants. Twenty-four (24) West African Dwarf (WAD) goats with average body mass of 6.5 ± 0.22 kg were used in a 84-day feeding trial to determine the influence of whole Water Hyacinth (WH; ) plant as alternative livestock feed resource. The goats were divided into four (4) groups of six (6) animals per group. Each group was randomly allotted to the four experimental diets containing 0 %, 5 %, 10 % and 15 % of WH, respectively, in a Completely Randomised Design. Results showed that supplemented plant influenced ( < 0.05) the growth performance characteristics of West African dwarf (WAD) goats. Five (5 %) percent inclusion of WH gave the highest ( < 0.05) weight gain, metabolic weight and dry matter intake whereas 10 % inclusion of WH gave similar ( > 0.05) weight gain as the control. In addition, 5 % percent inclusion of WH reduced ( < 0.05) the cost of production with high returns. On the other hand, with 10 % inclusion we observed the highest ( < 0.05) packed cell volume, red blood cell count and haemoglobin concentration. The 15 % WH inclusion resulted in an elevated ( < 0.05) serum albumin and cost per kilogram weight gain. It can be concluded that feeding WAD goats with WH up to 10 % in their diets had favourable effects on growth performance, health and possibly immune response as well as profitability.